Evaluation of population interventions in dietary public health

This programme is developing understanding of the factors influencing effectiveness, equity and acceptability of population, and other, interventions in dietary public health. This is currently being achieved through evaluations of a number of interventions. The ultimate aim of the programme is to inform the development & implementation of population dietary interventions that achieve an ‘optimal’ trade-off between effectiveness, equity and acceptability.

The personal and societal costs of unhealthy diets are huge. In the UK, diet-related ill-health costs the NHS around £6bn annually. Unhealthy diets are socio-economically patterned and account for around 25% of the UK association between socio-economic position and mortality.

Despite substantial effort locally, nationally, and internationally to address poor diets, the situation is not improving. We need to develop and test more and better strategies to improve diets to promote health, prevent disease and reduce inequalities.

Population interventions are those delivered to whole populations irrespective of individual disease risk – e.g. calorie labelling, food reformulation, and restriction of junk-food advertising. They contrast with high-risk interventions, targeted at those with high baseline disease risk.

Population interventions may be more effective and equitable, but less acceptable to a range of stakeholders, than high-risk interventions. However, specific evidence on the effectiveness, equity and acceptability of population dietary interventions is sparse.

Population interventions tend to be delivered by large organisations, particularly governments, and can have small individual effects – although these can accrue to large population benefits. This means that randomised controlled trials can be impractical and inconclusive. Innovative, natural-experimental, strategies are needed.

This programme is addressing these gaps by exploring the effectiveness, equity and acceptability of a range of population dietary interventions through a range of natural-experimental evaluations. This will lead to generic learning on the underlying factors influencing the effectiveness, equity and acceptability of population dietary interventions.